Heartburn in Children: Is it GERD or acid reflux?

It is normal for babies, children and teenagers to occasionally get acid reflux after eating. This burning sensation in the chest is also known as heartburn and is generally harmless.

When acid reflux happens a lot, your child may have gastroesophageal reflux disease, or GERD. GERD is not only uncomfortable. If left untreated, GERD can lead to:

  • Breathing problems
  • Inflammation of the esophagus
  • Failure to thrive
  • Barrett’s esophagus, which is a precancerous condition  

At the University of Chicago Comer Children’s Hospital, our experienced pediatric gastroenterologists are experts at diagnosing and treating GERD in children of all ages, from infants to teenagers.

GERD: Common Cause and Symptoms

GERD is often caused by a weak sphincter muscle in the esophagus, which is the tube that connects the stomach to the mouth. As a result, food and stomach acids can flow up the esophagus to the throat, instead of moving down to the stomach.

In addition to frequent heartburn, children with GERD may have other chronic symptoms, including:

  • Swallowing problems
  • Bad breath
  • Nausea
  • Breathing problems
  • Chronic cough

Signs of GERD in Babies and Toddlers

GERD symptoms may be different in very young children and infants.

Younger children with GERD may not experience heartburn. If they do, they may have trouble describing the feeling. Instead they might complain of stomach or chest pain or become unusually irritable after eating. Other symptoms include sour breath, refusing to eat and spitting up food or vomiting.

Younger children with GERD may not experience heartburn. If they do, they may have trouble describing the feeling. Instead they might complain of stomach or chest pain or become unusually irritable after eating. Other symptoms include sour breath, refusing to eat and spitting up food or vomiting.

Treating GERD in Children and Teens

Lifestyle and diet changes, along with prescription medications, can help resolve GERD in many children and teenagers.

Patients often benefit from avoiding certain high-acid foods (e.g., tomatoes) as well as spicy, greasy and high-fat foods. Some children may also benefit from losing excess weight or eating smaller meals more frequently. Parents and caregivers can team up with our experienced dieticians to test various diet changes and monitor their child’s symptoms.

Prescription medications for GERD include histamine-2 blockers and proton pump inhibitors. These drugs can be very effective in treating GERD that does not respond to diet changes. Our pediatric specialists can talk with you about any possible side effects your child may experience with these drugs. Most children eventually stop taking the medications after their esophagus heals and GERD symptoms diminish.

If medication and lifestyle changes fail to improve a child’s symptoms, our pediatric gastroenterologists may recommend endoscopy. This involves threading a thin tube (endoscope) down the throat and into the esophagus, stomach, and first portion of small intestine. Children are sedated during the procedure.

A tiny light and camera on the endoscope allow our physicians to see the esophagus up close and collect tissue to determine what is causing or contributing to your child’s symptoms. The test may also reveal other esophageal conditions, such as eosinophilic esophagitis, that produce GERD-like symptoms.

For teenagers preparing to transition to an adult specialist, our pediatric gastroenterologists can easily help transition their care to the experts at the UChicago Medicine’s Center for Esophageal Diseases.

Pediatric GI Specialists